Objective : To explore the clinical application of an extended clavicular epithelial flap with a transverse cervical arterial blood supply in the repair of postoperative soft tissue defects in elderly patients with oral cancer. Methods: From January 2015 to June 2018, 24 elderly patients with oral cancer were admitted to the Department of Oral and Maxillofacial Surgery, Hainan Provincial People′s Hospital, including 15 males and 9 females, aged 65-82 years, with an average age of 71.8 years. The supraclavicular epithelial flap was used to repair the soft tissue defect after radical resection of the oral cancer. The flap was at least 4 cm × 6 cm, and the maximum size was 7 cm × 9 cm. All patients completed a University of Washington Quality of Life (UW-QOL) survey 6 months after surgery, and a subjective satisfaction survey was conducted. Results : The prolonged clavicular epithelial flap survival rate was 91.6% (22/24). The patients had good speech and swallowing function, hidden scars and no obvious sequelae. The average UW-QOL score 6 months after the operation was 76.5 ± 6.4. The follow-up satisfaction rate was 87.5% (21/24). Conclusion An extended clavicular epithelial flap with a transverse cervical arterial supply is reliable, of moderate thickness, is simple to implement, causes little trauma at the donor site, and yields a relatively concealed donor site. It is suitable for the simultaneous repair of soft tissue defects in elderly patients with oral cancer.